Taoiseach expresses his 'full confidence' in James Reilly

Taoiseach Enda Kenny has said Health Minister James Reilly has his “full support and confidence” and that he expects the new ministerial team in the Department of Health to “move on” following last week’s row.

Roisín Shortall resigned as minister of state for primary care last week following a public disagreement with Dr Reilly over the location of primary care centres. She was replaced by Alex White, whose appointment will be confirmed at Tuesday’s Cabinet meeting.

Yesterday Ms Shortall has claimed her attempts to reform the health service were blocked by Dr Reilly and she said his failure to tackle "big ticket issues" such as consultants' pay and drug costs would lead to "the most appalling cuts" in the budget.

Mr Kenny last night said he had not heard Ms Shortall’s interview on RTÉ Radio One yesterday morning, during which she said Dr Reilly’s decision to include two centres in his constituency on the final list as “stroke politics”.

Mr Kenny said Dr Reilly had outlined in the Dáil during the week the reasons for including Swords and Balbriggan in the list of locations.

Speaking ahead of the Fine Gael presidential dinner in Dublin last night, Mr Kenny thanked Ms Shortall for her work and said there was now a “changed scene” in the Department of Health.

“I expect Minister Reilly and his two ministers of state to move on now with great diligence to see that the programme is implemented in the interests of everybody,” Mr Kenny said. Kathleen Lynch is minister of state for mental health.

“I expect that team to get on with implementing the programme in regard to health, which is a fundamental part of the programme for government. The structures in the health system have been around for a very long time.”

Mr Kenny declined to answer directly a question about whether or not he had considered moving Dr Reilly from his current portfolio. “Minister Reilly has the full support and confidence of the Government,” he said.

Speaking yesterday, Ms Shortall had questioned Dr Reilly's commitment to the programme for Government and denied there was a personality clash with her senior colleague.

A spokesman for the Minister flatly rejected her claims, however, describing them as "inaccurate". He said it was the former Labour junior minister who had questioned the programme for government and claimed she had questioned an agreed element of the programme that deals with health insurance when addressing the Dáil last week. .

Ms Shortall said her resignation had been coming for some time. "There was a situation developing over a number of months, where it was quite clear that James Reilly and I weren't on the same page. I don't believe he really subscribes to the programme for government, and there were fundamental differences."

Ms Shortall said there had been a "drift" in commitments made for the health service and said Dr Reilly was going in a "whole different direction" toward the American, business-based style of healthcare, and that her attempts at reform were "running into the sand".

"There are choices there," she said. "You can tackle the unacceptable drugs bill; we’re paying far too much for drugs or you can cut home help services. You can tackle consultants' pay and put a cap on pay or you can impose charges on people with medical cards, There are all kinds of choices."

She said Dr Reilly had "signed up to a health budget which could have been balanced this year if he had followed through on the commitments he had given to tackle those big ticket items within health.

"You have insurance costs, drug costs, consultants' pay. And the budget is predicated on him doing that, but he hasn’t and now we are coming to the end of the year, and we are going to be facing the most appalling cuts because of his failure to tackle those issues."

She said Dr Reilly was “very much about the insurance companies running the health service and privatising large parts of the health service”.

Ms Shortall also said she felt "let down" by the Labour Party over the issue, and that she resigned the party whip due to lack of backing. "If the Labour Party isn't about allocation of resources according to need . . . what is it about?"

The former junior minister claimed there had been a "certain closing of ranks" and "certain attempts to smear" in sections of the media.

She said she had spoken to Tánaiste Eamon Gilmore by phone about her resignation - rather than just emailing him - and that he had asked her to reconsider her decision.

Ms Shortall revealed she had considered resigning in July but said that there was a question mark over Dr Reilly's future as Minister at that time. She had also considered resigning when former HSE chief Cathal Magee departed, claiming he was "driven out of his job".

Asked why she had voted confidence in the Minister for Health, Ms Shortall replied if he she had voted no confidence in him, it would have been a "one-day wonder" and argued she had a responsibility to set out her beliefs over the lack of reform and future direction of the health service.

She also said that the description of the health service as being "like Angola" was a "cop-out".

Referring to the addition to a list of two primary-care centres from Dr Reilly's constituency, Ms Shortall said she agreed with the description of that being "stroke politics".

Dr Reilly's spokesman questioned much of what was contained in the interview and highlighted Ms Shortall's recent comments on health insurance - which, he said, proved she was out of step with the government programme.

“In her final words in her recent Dáil statement, Ms Shortall asked whether we should have a social insurance model or a commercial insurance model in establishing universal health insurance,” Dr Reilly's spokesman said.

He said the programme contained a commitment to give everyone a choice between competing insurers. “It has already been agreed by both parties that universal health insurance with competing insurance companies provides the best method for developing a single-tier health service with a dynamic for reducing costs and increasing efficiency.”

He would not comment on the record on the substance of Ms Shortall's’s claims that Dr Reilly had failed to tackle the issue of consultants' pay or drug prices.

Fianna Fáil's health spokesman Billy Kelleher said Ms Shortall had “laid bare the dysfunction within the Department of Health under James Reilly’s leadership” and had “exposed the cynicism of the decision of [Labour TDs] to vote in support of Minister Reilly during my motion of no confidence”.

He said the interview also “confirmed what Fianna Fáil has been saying about Cathal Magee being forced out as CEO of the HSE. It was blatantly obvious since the start of the year that the HSE budget deficit was out of control - instead of addressing Mr Magee’s concerns, Minister Reilly decided to drive him out”.

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